Provider Demographics
NPI:1679544571
Name:MCADAMS, LISA (APN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WRIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6240
Mailing Address - Country:US
Mailing Address - Phone:501-321-9803
Mailing Address - Fax:501-321-0710
Practice Address - Street 1:620 W GROVE ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4414
Practice Address - Country:US
Practice Address - Phone:870-862-0801
Practice Address - Fax:870-862-3687
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01509363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
P15509Medicare UPIN
AR5U960Medicare ID - Type Unspecified